Language：Japanese   Publisher：(一社)日本歯科医学教育学会  

新潟大学病院歯科医師臨床研修では,指導歯科医による研修歯科医の診療観察を用いて形成的評価を行っている.今回は評価者に歯科衛生士を加えてその効果を検証した.対象は令和元年度の研修歯科医22名とし,Yes/Noで判断する6つの評価項目と判定基準,合格要件をあらかじめ説明した後,自己申告により指導歯科医,歯科衛生士による診療パフォーマンス評価Competence Assessment(CA),CA by DHを実施した.CAは,保存,補綴,口腔外科領域において各1回ずつ合格することを求め,CA by DHの受検は努力目標として,歯科衛生士の診療介助を必要とする処置に対象を限定した.結果の分析は,CA,CA by DHおよびこれらに対するアンケートについてデータを収集することができた,16,22,22,21名分について行った.CAの平均受検回数は1.3回,初回合格率は69.3%であり,CA by DHの合格率は63.6%で保存系処置を対象としたものが多かった.CAでは診断に基づく処置の実践,器材使用上の注意遵守,CA by DHでは器材準備や介助者への配慮についてNoと判定される傾向が高く,専門職によって評価の観点は異なることが示された.また,いずれにおいても複数の評価項目でNoと判定されるケースが認められたが,対象処置とNoの判定された評価項目の間に一定の傾向はみられなかった.アンケートではCA,CA by DHを肯定的に受け止める回答が比較的多くみられた.以上より,さらなる改善を要するものの,歯科衛生士による研修歯科医の診療評価の有用性が示唆された.(著者抄録)

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Authorship：Lead author  

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Language：Japanese   Publisher：日本総合歯科学会  

【目的】歯科臨床技能教育の効率化は喫緊の課題と思われる。本研究は,この課題を解決するための第一歩として,技能習得において可視化できないにもかかわらず重要な要素と考えられる診療動作や器具の扱いを定量的に解析することを目的として実施した。【方法】動作計測には光学式3次元動作解析装置(VICON,Oxford,UK)を用いた。被験者は臨床経験5年以上の男性歯科医師6名(平均年齢38.3歳,歯科医師群1)と臨床実習中の本学歯学科6年次男子学生6名(平均年齢24.6歳,学生群),および経験10年以上の歯科医師5名(平均年齢43.8歳,歯科医師群2)と研修医歯科医6名(平均年齢27.3歳,研修歯科医群)とし,被験者と各種器具に赤外線マーカを設置してVICONで計測することにより,それぞれの動作を定量的に解析した。被験動作はマネキンに装着した下顎模型の下顎第一大臼歯への浸潤麻酔(9時,12時のポジション)と,自作した金属板に設けたI型,C型の溝に対する印象採得とした。【結果】ポジション毎の浸潤麻酔動作において学生群は注入速度が有意に速く(9時p=0.01,12時p=0.04),印象採得動作において研修歯科医群はC型の溝の印象体に生じたエラー数が有意に多かった(p=0.01)。【結論】本装置を用いて歯科治療の動作解析を行うことは可能であったが,歯科臨床技能教育に定量的解析や客観的評価を導入することを目指して発展させるためには解析項目等を検討していく必要があると思われた。(著者抄録)

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Language：Japanese   Publisher：日本総合歯科学会  

我々は,歯科治療時に術者が患者や患歯に与える力のコントロールを技能教育における重要なポイントの一つと捉えて調査を進めてきた。しかし,歯科臨床技能は術者個人の経験や手に関する身体的特徴等に影響される可能性があると考えられる。そこで,本研究では術者の性別,握力や手の大きさ(手長)と処置時の力の大きさの関係性を調査した。研修開始直後の研修歯科医22名(男性9名,女性13名,平均年齢26.2±2.1歳)を対象に,歯周ポケット検査(PPE),歯肉圧排(GR),抜歯(EXT),全部鋳造冠の装着(FMC)および全部床義歯の印象採得(FD)における力の大きさと被験者の握力および手長を測定した。その結果,PPEを実施する際の力の大きさは女性,握力および手長については男性の方が有意に大きいことが明らかになった。また,処置時の力の大きさと握力・手長については,FDでは被験者の握力が強いほど,処置中の力が大きい有意な正の相関を認めた(r=0.501)。一方,PPEでは,握力・手長が大きい被験者は処置中の力が小さい傾向が認められたが,有意な負の相関は認められなかった。以上より,研修歯科医の握力や手長によって,歯科治療時の力の大きさに個人差を生じる可能性があることが示された。今後もさらに詳細な調査を継続し,将来的に握力や手長に関する個人差を考慮した指導方法を開発することによって,歯科臨床技能教育の効率化に寄与すると考えられた。(著者抄録)

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Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：Japanese   Publisher：日本顎口腔機能学会  

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Language：Japanese   Publisher：Japanese Dental Education Association  

<p> <b>Abstract</b> This study aimed to use a custom-made dental simulator with force gauge for training of force acceleration during dental practice. Twenty-one trainee dentists at Niigata University Hospital participated and performed mandibular complete denture fit testing for adjustment. For all of the subjects, their force acceleration of denture fit testing (F₀) was measured after receiving a lecture on the experimental procedure and appropriate force (50 N) for the procedure. They were divided into two groups of 11 (group I) and 10 (group II). Group I practiced experience-based learning of 50 N force magnitude with the simulator. Each group was re-divided into two new groups, IA and IB, IIA and IIB. References to confirm the area to be adjusted were provided for A and B as photographs and as photographs with explanation respectively, and the force acceleration of denture fit testing was measured again (F₁). All of the procedures were done using denture-applied DENT-SPOT and the subjects were requested to explain the area to be adjusted. The answers were compared with the convex previously equipped on the alveolar ridge to calculate the correct answer rates. Prosthodontists were also asked to perform same investigation for the result of the fitting test on F₀ measurement and the correct answer rate was calculated. The results revealed that the force magnitude of F₀ to F₁ significantly increased in group I and there was no difference in group II. The correct answer rate between A and B also showed no difference. However, the force magnitude was correlated with the number of the area judged by prosthodontists. It is suggested that the device, with further improvements, might be useful for education on denture fit testing.</p>

DOI： 10.24744/jdea.36.2_63

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Authorship：Lead author   Language：Japanese   Publisher：Japanese Dental Education Association  

<p> <b>Abstract</b> Education for clinical techniques in dentistry faces difficulticulties such as factors concerning technical elements and the skills of handling various instruments properly, and the ideal educational method has not yet been established. This study aimed to solve the problem by measuring actual postures and motions by capturing the motion of the human body.</p><p> Seven male dentists and nine male 6th-year dental students in the Faculty of Dentistry, Niigata University participated in the study as the "dentist" group and "student" group, respectively. An optical motion capture system was applied to the participants to analyze their motions when preparing class I inlay cavities with an air turbine and diamond points.</p><p> The loci of the top of the diamond point were significantly different between the two groups and the preparation time of the dentist group was shorter than that of the student group. The dentist group did not move the wrist and elbow during preparation, and their head or chest kept a certain distance from the artificial teeth. During the practice, it appeared that the dentist group kept their upper bodies stable, whereas the students tended to control the air turbine only using the wrist and elbow while lowering their head.</p><p> The results revealed that this system can quantitatively analyze actual dental motions, including the positions of instruments and the upper body or trunk of the subjects.</p><p> It was also suggested that analysis by the system might be helpful to develop an objective method of assessing dental practice, although further investigation is needed.</p>

DOI： 10.24744/jdea.36.2_71

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Language：Japanese   Publisher：(一社)電子情報通信学会  

歯科の補綴治療では、印象材を用いて修復する歯列の型をとる「印象採得」という作業を行う。その技術は、歯科教育での実習および臨床経験を通じて習得するが、歯科教育における教師の指導が一般に定性的かつあいまいという問題がある。そのため歯科教育では、定量解析に基づいた指導法の確立が強く求められている。この問題を解決するために、本研究では、印象採得時におけるシリンジ先端の位置・姿勢および印象材の注出量を、光学式モーションキャプチャシステムを用いて同時計測するシステムを開発した。予備実験の結果、臨床評価で求められる精度で分析パラメータが計測できることを確認した。(著者抄録)

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Language：Japanese   Publisher：(公社)日本補綴歯科学会  

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Language：Japanese   Publisher：Japanese Dental Education Association  

<p> <b>Abstract</b> Clinical practical training in the clinic is considered to be one of the most important educational programs for dental education. However, the period of clinical practical training at each university is regulated by its own curriculum, so it is necessary to improve learning strategies for clinical practice. Our research team has focused on this theme and our previous reports revealed that learning how to control the force acceleration during various procedures (dental force control) might be effective for improving or developing practical dental skills. Sixty-three trainee dentists and 15 dentists with over 10 years of experience working at Niigata University Hospital participated in this study and their dental force when performing five kinds of dental procedure was measured. Periodontal pocket examination (PPE), gingival retraction (GR), tooth extraction (EXT), full metal crown mounting (FMC) and impression for complete dentures (FD) were employed as frequent dental procedures. Dental force measurements were performed twice for 25 and 38 trainee dentists in April as the early stage (TD-E) and in February as the late stage (TD-L), respectively. The measured dental force was significantly different between TD-E and dentists (D) on TE, TDs and D on FMC. It is suggested that there may be an appropriate force to be applied for each dental procedure and that clinical experience might affect the dental force control. It is also suggested that demonstrating an appropriate force for each procedure might improve the learning of clinical practice. Further investigation will elucidate an appropriate dental force for each dental procedure and the amount of clinical experience or target force values required to acquire dental force control.</p>

DOI： 10.24744/jdea.35.1_3

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Language：Japanese   Publisher：(一社)日本歯科医学教育学会  

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Language：Japanese   Publisher：日本総合歯科学会  

超高齢社会を迎え,歯科医療機関を受診する高齢者,有病者の割合は増加している。安全な歯科医療のためには全身状態の把握が欠かせない。一般に患者の全身状態は初診時の医療面接で聴取されるが,自身の健康状態を正しく理解していない場合もある。本研究の目的は,新潟大学医歯学総合病院歯科の初診患者の自己申告に基づく全身疾患罹患状況について臨床統計的観察を行い,有病率の特徴と初診時医療面接上の留意点を明らかにすることである。2015年度1年間に新潟大学医歯学総合病院歯科の予診室を受診した初診患者1,258名の予診記録を調べた。男女比は男性38.2%,女性61.8%,65歳以上の者は全体の34.7%であった。一人当たりの全身疾患数の平均は40歳代で1以上,60歳代で1.5以上,70歳代では2以上であり,年齢とともに増していた。高頻度で認められた疾患は,高血圧(17.1%),高血圧以外の動脈硬化性疾患(心血管疾患,脳血管疾患等)(9.3%),がん(9.2%),糖尿病(6.4%)であった。60歳以上に限るとこれらの有病者率は上昇し,高血圧,がん,糖尿病はほぼ倍増した。骨粗鬆症は70歳代で9.0%に認められた。高血圧,糖尿病の有病率は低くはなかったが国民健康・栄養調査の値を下回っており,自己申告しない,病識の不十分な有病者の存在が示唆され,聴取時の工夫とともに,医科への対診,受診勧告などの医科歯科連携の必要性が再確認された。(著者抄録)

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Other Link： http://search.jamas.or.jp/link/ui/2017354019

Language：Japanese   Publisher：Japanese Dental Education Association  

<p> <b>Abstract</b> The qualitative improvement of educational ability of dental instructors is indispensable for practical dental education. The aims of this study were to verify the influence of clinical instruction evaluation by trainee dentists on developing the instruction ability of dental instructors and to motivate their educational activity.</p><p> Six senior dental instructors and seven assistant dental instructors in the dental trainee program of Niigata University Medical and Dental Hospital in 2015 were included in the study. Twenty-two trainee dentists evaluated the clinical instruction of the dental instructors using a Maastricht clinical evaluation sheet at the end of the training period, and the evaluation results were fed back to each instructor. Then, a questionnaire survey of the instructors was carried out.</p><p> The senior dental instructors considered that the evaluation by the trainee dentists was reasonable and that the evaluation was necessary. Half of the assistant dental instructors answered that the evaluation was useful and will use it for their future instruction, however, some of them seemed to become aware of their role as an instructor for the trainee dentists. Both senior and assistant instructors indicated that clarifying the points to be noted in instruction was meaningful for all instructors to reach a consensus on the way of clinical instruction, thus improving the clinical training system.</p><p> Clinical instruction evaluation of instructors by trainee dentists may be useful to improve the motivation for developing clinical educational ability and accepted willingly by dental instructors.</p>

DOI： 10.24744/jdea.33.1_12

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<p> <b>Abstract</b> Dentists are required to adjust the force they apply at an appropriate level for each procedure. Therefore, it is essential for dental students and trainee dentists to manage the dental force and to learn dental treatment techniques. Our previous report revealed clear differences in dental forces applied by instructors and students. This study investigated the process of learning the dental force in postgraduate clinical training. The dental forces applied by 22 trainee dentists were measured at the early stage (June) and the late stage (February) using a custom-made dental mannequin equipped with a digital force gauge (IMADA) under the mandible. Periodontal pocket examination (PPE), gingival retraction (GR), removing subgingival calculus (SRP), tooth extraction (EXT), impression for full denture (FD) and full metal crown mounting (FMC) were selected for the dental force measurements as frequent dental procedures. The median peak forces for PPE, GR, SRP and EXT and the maximum values of FD and FMC were recorded at each stage and analyzed with statistical methods such as the Wilcoxon signed-rank test or Mann-Whitney U test. As a result, significant differences were found in the data for EXT and FD. However, there were no significant differences concerning PPE, GR, SRP and FMC. It was suggested that the trainee dentists could improve their dental force management through clinical experience in postgraduate clinical training.</p>

DOI： 10.24744/jdea.32.3_166

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Language：Japanese   Publisher：Japanese Dental Education Association  

<p> <b>Abstract</b> The basic skills required for dentists include using a suitable force for each procedure in addition to dealing with materials appropriately. However, it is difficult to teach force acceleration at the clinical site of dental procedures. Dental students and trainee dentists need to learn about the appropriate force (dental force) from their own study. Ten dental students in the clinical training curriculum and 10 dental instructors participated in the survey. The dental force they used for five dental procedures was measured by a mannequin equipped with a scale under the mandible. Periodontal pocket examination (PPE), gingival retraction (GR), grinding of dental caries (GDC), and mounting of a full metal crown (FMC) and removal partial denture (RPD) were prepared as procedures that require various forces from delicate to relatively high force. The force data were divided into a student group and a dental instructor group and analyzed with statistical methods. The results showed that the student group tended to use larger force than the dental instructors for PPE or GR, but tended to use a smaller force than dental instructors for FMC and RPD mounting. There were significant differences between the two groups in all five procedures. Furthermore, significant differences were found between PPE and GR, and between FMC and RPD in the dental instructor group. It is suggested that the force acceleration used by dentists is closely related to their clinical experience.</p>

DOI： 10.24744/jdea.32.1_22

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Language：Japanese   Publisher：The Japan Society of Mechanical Engineers  

<p>In order to construct the skill acquisition method for a common treatment of dental caries, it is necessary to prepare quantitative guidelines for Dental students.</p><p>In this study, measurement and analysis for the movements of fingers and turbine have been conducted during tooth removal and restoration process using three-dimensional motion capture. Through the comparison and examination of them, validity of the constructed system has been confirmed in this paper. Moreover, the differences in cutting techniques between skilled doctors and beginner students have been discussed.</p><p>Especially, effectiveness of locations for the reflective marker for the motion analysis on the fingers from the viewpoint of improvement for the imaging environment.</p>

DOI： 10.1299/jsmermd.2020.1P2-M08

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Language：Japanese   Publisher：Japanese Society of Stomatognathic Function  

DOI： 10.7144/sgf.24.126

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Language：Japanese   Publisher：Japanese Society of Stomatognathic Function  

DOI： 10.7144/sgf.24.118

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Language：Japanese   Publisher：日本歯科医学教育学会  

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Language：Japanese   Publisher：日本歯科医学教育学会  

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Language：Japanese   Publisher：Japanese Society of Stomatognathic Function  

DOI： 10.7144/sgf.23.30

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Event date： 2020.9 - 2020.10

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